elevated birth

Copyright 2019

It’s the holiday season, and that means interaction with family members you may see just a few times a year. Even if you have wonderful relationships with your extended family, if you are pregnant around the holidays, conversations can get difficult when talk turns to your plans for birth. Everyone seems to have an opinion to share about what you should or shouldn't do, or they offer a prediction of how your birth will go. 

Here are five tips to navigate the holidays while pregnant:

1. Modify your holiday plans. Modify your plans, and minimize your stress. If you usually host a family gathering, ask someone else to host this year. Plan on bringing in prepared foods instead of cooking, or make the dinner a potluck event. 

Can you limit family time this year? Use your pregnancy to your advantage. Perhaps you stay for just a few hours at your sister’s house instead of the whole day. Or take a nap while everyone else is watching football. 

If you are nearing your estimated due date, your care provider may actually warn against you traveling more than a couple of hours from your home. That means you can avoid a prolonged visit with family altogether, if that is your preference.


2. Prepare for difficult conversations. Chances are, your family members are excited about the new addition to their own extended family. But instead of only sharing in your excitement, they may also feel the need to share their opinions.

Conversation will inevitably turn to your pregnancy, and will likely consist of three topics:

• Questions about where and how you plan on giving birth 
• Their opinion on your answers, and
• Negative stories about their own births or those of people they know

If you are making choices for your birth that are different from those your family members have made for themselves, be prepared for push back. You might hear things like, “Just you wait! You have no idea!” or “You’ll change your mind!”

If your choices are vastly different, you may even hear things like “You are putting your baby’s life in danger!” or “You are being selfish.”

With pregnancy hormones at play, and if you yourself are still navigating your birth options, these conversations can get heated, emotional, and very difficult.

If you anticipate these conversations in advance, you can avoid feeling blindsided. You might tell your family before the event (or have your partner tell their family) that you don’t want to have these conversations at all. Or, you may choose to be more selective or vague in your answers to probing family members.

elevated birth

Copyright 2018

​elevated birth
Copyright 2018

Baby, it’s HOT outside! It’s about that time of year that people are over summer, and are looking forward to sweaters and pumpkins and changing leaves. With today’s high of 108 degrees, I know I am!

This heat might feel worse to you if you are pregnant. You are carrying more weight than you normally do, your feet might be swollen, and you just can’t get comfortable at night. If you are early in your pregnancy, the heat can exacerbate the drowsiness that dominates your first trimester. 

So here are some tips to surviving this heat, my pregnant friends!

1. Hydrate, hydrate, hydrate! With baby pressing on your bladder, you may feel like you are always in the restroom, but that is no reason to hold off on drinking water. Staying well hydrated is important to prevent complications like low amniotic fluid, birth defects, and premature labor. Constipation, a common pregnancy woe, can worsen if you don’t stay hydrated. Eating foods with high water content, like watermelon, cucumber, lettuce, celery, radishes, bell peppers, and grapefruit can be helpful as temperatures rise. You can also avoid foods with caffeine, which acts as a diuretic and removes water from the body.

2. Enjoy the A/C. When temperatures soar, avoid strenuous exercise, which increases your body temperature and makes you sweat out water. Instead, put your feet up and enjoy the air conditioning. Before long you’ll be on your baby’s schedule, so when it's this hot outside, exercise your ability to relax!

3. Embrace the positives. If you’ve read my blog posts, you know that I’m a fan of “flipping the script.” What is a positive way of viewing a difficult or seemingly negative situation?

​Try to get on board with this positive thinking about having a baby in the summertime:

• When you go into labor, you don’t have to worry about inclement weather. When heading to the hospital or birth center, you don’t have to wonder  about whether or not the streets have been plowed or if there is ice on the road. If you are birthing at home, you don't have to wonder if your midwife or doula will be able to get to your house.
• By the time cold and flu season arrive, your baby will be several months old and will have some natural immunity built up. If you are breastfeeding, your baby gets the added bonus of immunity from your breastmilk.
• By the time ski season is in full swing, you might feel ready to leave your baby for a few hours to hit the slopes.
• When celebrating the holidays, you can have some wine at dinner, or some champagne on New Year’s Eve! 
• When you plan your baby’s first birthday, you won't be limited to indoor venues. Although if next year is as hot as this year, it might be too hot for a party at the park . . . 

Stay cool, everyone!

elevated birth
​Copyright 2018

I’m a big planner. When my husband and I went to Europe years ago, before we had kids, I researched for weeks to find the perfect hotels and activities within our budget, the trains that would take us from town to town, and how much money we would need for food per city, per meal, all laid out in a tidy spreadsheet that automatically adjusted based on that day’s exchange rate. 

Fast forward a few years later when we were expecting our first child: I knew that the baby could come as early as 37 weeks, and still be considered “at term,” and so I was prepared for his arrival at 37 weeks. All the baby gear was purchased, the newborn clothes were washed, the diaper changing station was stocked. Months before, we had taken all the classes— childbirth education, breastfeeding education, new parent preparation, and we had our doula booked. I was ready to have this baby.

Over a month later, I was still pregnant. What I was NOT ready for, was the waiting.

After a positive pregnancy test, one of the first things we learn is our estimated due date. One of the things we tend to ignore is the estimated part.

Due dates are not an exact science. The website Evidenced Based Birth gives a whole explanation of how due dates came to be, but in a nutshell, determining your estimated due date based on the first day of your last menstrual period was a technique created in the 1744 in the Netherlands, refined in 1812 in Germany, and then revised again in America in the 1900’s. This method doesn’t take into account the fact that not every woman has a 28-day menstrual cycle, that ovulation can occur earlier or later in a cycle, or that implantation time can vary.

Even if you’re aware that going past your estimated due date is normal, it can still be frustrating to be “overdue.” You might be feeling uncomfortable, as your baby is nearly his or her full size and pressing on both your ribs and your bladder at the same time. You might not be getting much sleep, as you wake up several times a night to pee, or you just can’t find a comfortable position to lay in. 

It can be especially frustrating when your family and friends view your estimated due date as an expiration date, and bombard you with texts and phone calls. When’s the baby coming? You haven’t given birth yet?! When are you getting induced? You look ready to explode!!!

These comments and inquiries are NOT helpful.
​
So if you find yourself pregnant at 40+ weeks, here is what to do when you are "overdue:"

1. Assume that you will go to 42 weeks. The mind is a powerful tool. Neuroscientist Robb Rutledge studies human happiness and developed a complex equation to predict happiness in a given situation. According to this New York Times article on his work, “How happy you are depends in large part on your expectations.” So if you expect your pregnancy to go past your estimated due date, you are less likely to be upset or frustrated when the bun in your oven needs a little more time to bake. And if your labor begins near or before your estimated due date, you may be pleasantly surprised.​

2. Tell your family and friends that your due date is actually two weeks later. Granted, this is an extreme measure. And if you’ve already announced your estimated due date to your family, to your co-workers, and on social media, it may be ineffective. Just know that there are other ways to share your good news in early pregnancy. You can announce that you are expecting a baby “in October,” or “late fall,” as previous generations once did. If this isn’t your first rodeo, and you experienced the barrage of inquiries with your first baby, then fudging that due date might not sound like a crazy idea after all.

3. Indulge. See all the movies you won’t be able to go see when your baby is here. Take all the naps. Go out to a fancy restaurant, or any restaurant that doesn’t have a kids menu. Get your nails done. Get a massage. Catch up on that show on Netflix you’ve been meaning to watch. Do whatever you want to do, while you have the time and energy to do it. It may be a while before you are in charge of your schedule again, so take charge of it while you can.

4. Take time to savor these last few days with your older kid(s). Taking care of other kids can be exhausting when you are pregnant. You just want to lie down for a few minutes, but they are suddenly resisting naps. They may seem more clingy or needy, and you wonder how on earth you will take care of both a toddler and a newborn??
Flip the script. Your little kid will be a big brother or sister in just a few days or weeks. You won’t have as much time to color together, or get on the floor and play with blocks, or take a walk to the park. Hold their little hands, which will seem huge after your new baby is born. Listen to their stories and field their incredible questions. Allow yourself to enjoy your older kid(s) in this moment, because everyone’s life is going to get a little shaken up when the new baby arrives.

5. Devote some time to postpartum planning. We focus so much on pregnancy, the baby shower, decorating the nursery, and the birth, and tend to neglect preparing for the postpartum period. We often think, “It will all work out” and “We’ll manage” without realizing that a little bit of planning can make a world of difference in how we feel after baby is here.

While binge watching A Baby Story, you can:

• Prepare freezer meals
• Work with a friend to create a Meal Train
• Consult a pet trainer to figure out the best ways to introduce your pet to your new baby, and to schedule walks for the first few weeks
• Create a schedule with close family members and friends about who can come over to help with the baby, or with household tasks
• Set up a grocery delivery account, like Instacart, so it’s ready when needed
• Create a list of local resources you may need immediately postpartum, like a pelvic floor therapist, lactation specialist, chiropractor, etc. You can visit my Parent Resources page for some local suggestions
• Interview and hire a Postpartum Doula to help you make a plan for the first few days/weeks/months after birth, depending on your family’s individual needs

6. Check in with your doula. Your doula can be a great source of informational and emotional support when you find yourself past your due date. If your care provider is bringing up induction as a possibility, your doula can help prepare you for the process, or let you know about possible options or alternatives that you can discuss with your care provider. She will let you know that you are supported, and that she is there if you have questions or need reassurance.
​
7. Practice mindfulness. Mindfulness is a skill that can be honed with practice. To be present in the moment, able to acknowledge and accept your feelings—good and bad— without judgment, you free yourself from allowing your emotions to control you. Being mindful can positively affect the way you live your life in general, but in the world of birth and parenthood, its effects are significant.

In labor, you can use mindfulness to accept the pain and discomfort you are feeling, and then let it go. This can help immensely with labor progress, with how you react to unexpected challenges, and how you end up feeling about your birth experience.

As a parent, you can practice mindfulness while you figure out breastfeeding, when you have to wake up in the middle of the night to attend to your baby, or when your toddler throws a tantrum in the grocery store.

So during pregnancy, as you wait for labor to commence, be mindful of what you are feeling. If you are tired, achy, sick of the constant text messages, fearful, or just ready to have this baby, acknowledge what you feel. Accept it, and let it go. Consider it preparation for your new life as a parent.
​
8. Find the good. What’s good about being “overdue?” Maybe you realize you do get some extra time with your partner as “just the two of us.” Maybe you get to attend that one last social event you weren’t sure you could make. Maybe your best friend from out-of-state will get to be there for the birth, after all. Maybe you know that when labor does start, you will be so thrilled you will welcome contractions instead of fearing them! Find the good in your situation and embrace the wait. 

elevated birth
​Copyright 2018

I am an avid podcast listener. One of my favorites is a podcast called “Death, Sex & Money.” In one episode, host Anna Sale interviews actress Ellen Burstyn. Ellen shares that now that she is in her eighties, living alone, she has finally allowed herself “Shouldless Days,” days where she does only what she wants to do and nothing she should do. She turns away from the inner critic who faults her for not doing what she should, and instead listens to what she truly wants and needs.

I often think about Ellen Burtstyn’s "Shouldless Days" and think to myself, "Is it easier to do this when you’re in your eighties, without the responsibility of little mouths to feed and hands to hold? Is it easier to do this as a financially successful famous actress, living alone in a lofty New York apartment?"

And my answer is, "Of course!"

But that doesn’t mean that we need let the “should’s” dictate everything in life. By choosing to not act from a “should” mentality in every instance, you allow room for self-compassion, a turn to joy, and you prioritize self care.

Just stopping to question the “should” helps you to decide what to keep and what to let go. Sometimes you agree with the “should.” It aligns with your core values. You begin to edit out the unnecessary, the harmful, the confusion, and the waste that does not serve you and your family.

There are many opportunities to practice this in pregnancy and postpartum. You are faced with so many “should’s.” With a new tiny human to prepare for and care for, the stakes seem even higher on figuring out what you should do.

Should I birth in the hospital?
Should I find out my baby’s sex?
Should I get genetic testing?
Should I get an epidural?
Should my mother-in-law get to be in the room when I give birth?
Should we circumcise our son?
Should we host visitors after the baby is born?
Should I be able to keep the house clean?
Should we co-sleep?
Should I introduce a bottle?
Should I go back to work?
Should my baby be sleeping through the night by now?
Should I be back to my pre-baby weight?

To be truthful, the “should’s” never end. Whether you are expecting a baby, have a newborn, a toddler, or a teenager, there will always be someone (maybe yourself), telling you what you should do in any given situation.

Before you automatically oblige, pause. Are you also listening to the voice of self-compassion? Are you taking care of your own needs, as well those of your baby and family? Are you making room for joy? Do you need help? Do you need more information? Is there another way? What does your intuition tell you? 

Amidst leaking breasts, a non-stop nursing baby, a clingy toddler, and a pile of laundry, if you can’t swing a Shouldless Day, try a shouldless pause. A breath. A chance to let go of what doesn’t serve you. A turn to what brings you joy, even a trace.

Maybe it's advocating for yourself in labor. Maybe it's saying "no" to a visitor. Maybe it's ordering pizza that night so you can sleep a little bit longer with your baby. Maybe it's asking someone else to bring the meal. 

Question the "should's." Listen to what answers follow.

elevated birth
Copyright 2018

This is a two-part series. Look for the first part in my previous post:
What this Doula Wants You to Know About Birth

elevated birth
Copyright 2018

This is a two-part series. Look for the next part coming soon: 
​What this Doula Wants You to Know About Postpartum

elevated birth
​Copyright 2018

As a doula, my kids are exposed to a lot of Birth talk. They ask questions about what I do, but I don't always know how much they have retained. Then one day over a year ago we were driving around and I heard the following exchange between my then 9 year old son and 6 year old daughter:

Daughter: A baby can come out of the woman's vagina or they can cut it out of the mom's belly.
Son: You mean a C-Section. Or, what's that other word, Mom?
Me: A Cesarean.
Son: Yeah, a Cesarean. But usually vaginal is better for the mom and the baby because the Cesarean is major surgery.
Daughter: Yeah, I'm going to have my babies born through my vagina.

The conversation didn't go much further than that. What struck me at the time was how comfortable they were with talking about birth, vaginal or otherwise. Perhaps because of what I do, in our family we make a point to use proper names for body parts; the vagina is different from the cervix and the vulva. The baby grows in a "belly," but they know that it's actually in the uterus.

The comfort my husband and I share regarding the facts and process of birth, has led us to share information about sex and development in an age-appropriate way with that same level of comfort. Recently I accompanied my son to a school-facilitated boys' puberty class. There were the expected dramatics-- giggles, groans, and feigned screams of horror at the mention of a girl's period-- but the factual manner in which my son absorbed the material made space for more than the facts. Because this information was not new to him,  extended conversations about feelings and expectations of his own development were possible. 

My daughter has added "doula or midwife" to her list of what she wants to be when she grows up (along with professional soccer player, teacher, and puppy rescuer). She asks a lot of birth-related questions, usually during bath time or right before bed. She asks, and I answer factually. If she asks further, we go further. Aside from facts, our conversations have gone deeper than I would have ever imagined at this age. One day she asked, "What if the woman wants to have sex but the man doesn't?" Internally giggling, I answered, "Both people need to want to have sex or else sex doesn't happen." Just like that, we began a rudimentary conversation about consent. 

Birth creates an opportunity to have these conversations, with our own kids, and with ourselves. Many of us did not grow up in households where sex or birth were discussed as normal events, or they weren't discussed at all. If birth was discussed, it was in negative terms, focused on pain, or bad moods, or absent and neglectful partners, or complications. Instead of pain and shame, we need to hear stories of perseverance and pride. 

It's normal and common to poop during pushing? Maybe we can let go of anxiety around that. The muscles of the vagina and pelvic floor stretch for birth? Maybe we can stop worrying about our vagina "never being the same." You had a 3/12/24/48 hour labor that ended in unmedicated vaginal/emergency Cesarean birth? Maybe we can praise ourselves for facing our fears and challenges to the best of our abilities, and let go of the rest.

Our views of our own bodies can affect the way we give birth. We might consider birthing in a different way than our parents or friends. We may take more care in choosing a care provider that respects our preferences for birth, who values and practices informed consent with their patients. Our relationships may be strengthened through pregnancy and birth, as we marvel in the bodies of our partners and their role in creating new life.

The kids we raise will benefit from our positive feelings about our bodies and our births. The child exposed to breastfeeding as a normal, non-shameful way to feed a baby may have an easier time in her own breastfeeding journey, or may be more supportive to a future breast-feeding partner. 

When we know what our bodies can do, we take ownership of our births. 

Birth is normalized. Shame loses its power. 

When we are body positive, we can positively birth.

elevated birth
Copyright 2018

Whether you grew up here or are a recent transplant, if you are expecting a baby in the Treasure Valley, you've picked a great place to procreate. Here's a list of reasons why:

1. Midwives Abound
​ Choosing a midwife as the primary care provider in pregnancy is a choice more and more people are making for their low-risk pregnancies. Midwives view birth as a normal life event, and tend to minimize interventions. Their care is more holistic, incorporating factors like nutrition and the social and psychological health of their patients alongside physical care. Midwives attend home births, births at freestanding birth centers, and in some hospitals.

In Idaho, all midwives are licensed by the state. They can be Certified Nurse Midwives (CNM), registered nurses with graduate education in midwifery, or Certified Professional Midwives (CPM), who are trained through a formal education program or through an apprenticeship. CPM's must pass a national certification exam. In the Treasure Valley, both types of midwives can be found practicing in a variety of venues. There are independent, traveling midwives who primarily focus on home births. There are those who see patients at birth centers, and either attend births there or at patients' homes. And within both major hospitals systems in the Valley, St. Luke's and St. Alphonsus, there are teams of Certified Nurse Midwives (CNM's) who work alongside obstetricians in the labor and delivery wards.

Midwifery and/or home birth is illegal in several states. In other states, poorly-defined or restrictive laws discourage midwives from practicing for fear of prosecution. Even in states where midwifery is legal and regulated, midwives are few in number, or not an option in local hospitals. The abundance of midwives in the Treasure Valley, and the variety of venues and patients they service, is impressive for a population of just under 700,000.
​
2. A Choice in Birth Centers
The Treasure Valley has four freestanding birth centers. FOUR! To put this number into perspective, the South Bay region of Los Angeles, which has roughly the same population as the Treasure Valley, has ZERO freestanding birth centers. You would have to travel in LA traffic for at least 30 minutes (double that in rush hour traffic) to get to the nearest birth center.

Not in the Treasure Valley! From Nampa to Meridian to Boise, you can opt for that middle ground between home birth and hospital birth and have plenty of options to choose from:
Boise

• Mercy Birth Center http://www.mercybirthcenter.com
• Treasure Valley Midwives https://treasurevalleymidwives.com

Eagle

• Boise River Birth Center & Women's Health https://www.boisebirthcenter.com​

Meridian

• New Beginnings Birth Center http://www.newbeginningsbirthcenter.com

3. The Valley's Hospitals are Growing and Innovating
Maternity services are offered at several locations in the Valley. Family-centered care and patient choice is a focus at the major hospitals.

St. Luke's offers maternity care in Downtown Boise, Meridian, and Nampa. The Nampa hospital is brand new, and offers specially designed family suites, with large labor tubs, refrigerators, and plenty of room for family. Especially innovative is the fact that several of these suites are NICU (Neonatal Intensive Care Unit) rooms, the first of their kind in the Northwest.

St. Alphonsus offers maternity care in Boise and Nampa. The Boise campus boasts a level III NICU, the highest level of neonatal care in Idaho. Its Nampa hospital is also brand new, growing to meet the demands of the Valley's expanding population.

In Caldwell, West Valley Medical Center offers family suites with king sized beds. There is no minimum age for visitors, so younger members of the family can get the opportunity to meet and bond with new babies before they get home. West Valley opened a brand new NICU last fall as well.

4. A Doula for Everyone
The community of doulas in the Valley is growing and thriving. As more people discover doulas, and the important role they play in supporting birth, there has been an increase in their demand. Different doulas service different segments of the population; depending on your specific needs, you can find a doula that aligns with your personality, values, and budget.

Doula associations and partnerships foster cooperation within the doula community, and strengthen and elevate the profession. I am a proud member of the following local doula organizations:

• Treasure Valley Doulas http://www.treasurevalleydoulas.com
• Idaho Doula Associates https://www.idahodoulas.com​

4. Finding your People
When illness reaches your family, whether you reach for the elderberry syrup or the Sudafed, there is a group for you. The Treasure Valley offers many different online forums and in-person meet-up groups to help you navigate the world of pregnancy and parenting in a way that speaks to you.

New to the area is Building Villages ​https://www.buildingvillages.org, an organization focused on early childhood development and parent support. Their pilot program for parents of newborns is launching next month. Meeting in Meridian or Boise, the Newborn Groups will meet for 10 weeks and will focus on the practicalities of raising a newborn and parent self-care, and will provide its participants with an opportunity to meet other new parents and build community. For more information, visit https://www.buildingvillages.org/newborn-groups/

5. Just Look Around You
In so many parts of the country, kids just don't play outside anymore. In the Treasure Valley, it's hard NOT to get outside. From the river, to the foothills, to the plentiful parks, this is an easy place to expose your baby to sunshine and fresh air. Getting out in nature is good for your own health and wellness, too.

Birth (and life) is better here!